Radical Logics and Their Carriers In Medicine: The Case of Psychopathology and American Obstetricians and Gynecologists

Abstract

Through an historical case study, this article addresses how and why physicians carry radical logics into medicine. The radical logic of focus is psychopathology. Obstetrics and gynecology was one of the very first specialties outside of psychiatry to incorporate this logic into its work culture. Employing a core-skill conflict perspective, this article shows that obstetricians and gynecologists’ failure to “deliver the goods” promised in their core-skill definition invited aggressive responses by general surgeons against their turf claims. Obstetricians and gynecologists embraced psychopathology in the early post-World War II period (1945 through the 1960s) to improve their diagnostic and surgical outcomes in the hope that this would drive surgeons away from their markets. Because of this market promise, obstetricians and gynecologists agreed to serve in a subordinate, screening role in their relationship with psychiatrists. The study illustrates the impact of both negotiated and conflictual interspecialty relations on the programs physicians use to carry radical logics into medicine. Keywords: medicalization, the medical profession, occupational sociology, women’s health, organizational innovation.